Healthcare Provider Details

I. General information

NPI: 1043199516
Provider Name (Legal Business Name): GOODLIFE PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1743 SMOKETREE DR
EL CENTRO CA
92243-4130
US

IV. Provider business mailing address

PO BOX 286
BLYTHE CA
92226-0286
US

V. Phone/Fax

Practice location:
  • Phone: 760-847-7044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANDREW RAMIREZ
Title or Position: PT
Credential:
Phone: 760-847-7044